Quality of Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury
Quality of Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury
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DOI：
10.1097/htr.0000000000000066
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发表时间：
2014-07-01
影响因子：
2.4
通讯作者：
Bayley, Mark
中科院分区：
文献类型：
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作者：
Bragge, Peter;Pattuwage, Loyal;Bayley, Mark
导言：创伤性脑损伤后的认知康复可以通过解决注意力、执行功能、认知交流和记忆方面的障碍来帮助优化功能、独立性和生活质量。本研究旨在确定和评估创伤性脑损伤后认知康复临床实践指南的方法学质量。方法：在2012年1月至3月期间对数据库和网站进行系统搜索，以确定从2002年起可免费获得的英文临床实践指南。符合条件的指南使用研究和评估指南II的验证评估工具进行评估。结果：符合纳入标准的11项指南由4名评分员独立进行评分。质量评价结果表明，准则一般采用了系统的搜索和评价方法，并提出了明确、明确的建议。相反，只有1个指南纳入了实施和审计信息，并且没有对制定、审查和确保建议的通用性以及纳入患者偏好的过程进行糟糕的报告。评价者之间一致性的组内相关系数显示，除1项(中度一致性；组内相关系数=0.76)外，所有指南的一致性都很高(组内相关系数为0.80)。结论：未来的指南应该通过提供实施信息和审计标准，以及更好地报告指南制定过程和利益相关者参与来解决已确定的限制。
Introduction: Cognitive rehabilitation following traumatic brain injury can aid in optimizing function, independence, and quality of life by addressing impairments in attention, executive function, cognitive communication, and memory. This study aimed to identify and evaluate the methodological quality of clinical practice guidelines for cognitive rehabilitation following traumatic brain injury. Methods: Systematic searching of databases and Web sites was undertaken between January and March 2012 to identify freely available, English language clinical practice guidelines from 2002 onward. Eligible guidelines were evaluated using the validated Appraisal of Guidelines for Research and Evaluation II instrument. Results: The 11 guidelines that met inclusion criteria were independently rated by 4 raters. Results of quality appraisal indicated that guidelines generally employed systematic search and appraisal methods and produced unambiguous, clearly identifiable recommendations. Conversely, only 1 guideline incorporated implementation and audit information, and there was poor reporting of processes for formulating, reviewing, and ensuring currency of recommendations and incorporating patient preferences. Intraclass correlation coefficients for agreement between raters showed high agreement (intraclass correlation coefficient > 0.80) for all guidelines except for 1 (moderate agreement; intraclass correlation coefficient = 0.76). Conclusion: Future guidelines should address identified limitations by providing implementation information and audit criteria, along with better reporting of guideline development processes and stakeholder engagement.